RadioGaGa
06-09-19, 20:37
Hello everyone
I've been really quite busy this week (first week back to work) and have had a few friends birthday gatherings to attend.
Anyway, as some of you probably know, there had been a concern raised about the circulation to my legs/erectile dysfunction, and the Cardiologist was certain I maybe had some form of vasculitis, thus referring me back to the GP to see a vascular surgeon.
The GP immediately disagreed with the Cardiologist, saying he was wrong as it's uncommon at my age without diabetes etc, but he agreed to do the Ankle-Brachial Index test. So that was booked for Thursday 29th August. I went to the surgery to have the practice nurse perform the test, only to be told I hadn't been booked in for a long enough appointment (it takes about 15 mins + 15 mins of relaxing lying down before hand).
So I was booked in for Tuesday just past. I went in and the nurse said immediately (in a friendly sort of way) "Oh, another diabetic who hasn't controlled their sugars!" to which I said, "No, actually, I don't have diabetes". So her face went a tad confused and she told me to lie on the examination table for about 15 minutes and then she'd begin the test.
Those 15 minutes were the longest 15 minutes of my life.
After what seemed like 15 months, the nurse returned and then got her doppler out and found the brachial pulses. They sounded so clear, it was as if they were in my ear. So, this gave me an idea of what to expect with the ankle (tibial) and pedal (doralis pedis) pulse.
The nurse then examined the left arm, and there was only a minor interarm difference (about 2mmHg, which is entirely normal - a good sign). She then moved down and examined the tibial pulses using the doppler: again, both these pulses sounded as if they were in my ear, they were that clear.
But then came those elusive dorsalis pedis pulses.
She tried the left foot first, and after about 30 seconds it became apparent she had trouble finding the pulse. I said "having trouble?" to which she said "a bit". But then, we heard the pulse. Only this pulse was obviously different to the others - it sounded as if it was at the other end of the room; not as loud or forceful. She also didn't inflate the blood pressure cuff as much as the other leg pulses, indicating the pressure wasn't as high in this artery. The same happened for the other foot, only the pulse was a tad louder.
She then donned a "poker face" and said she was off to calculate the results and speak with the doctor (another sign something wasn't normal).
I sat there actually feeling fine - this has been going on for a while and it's only now they are taking me seriously. So she arrived back with the doctor, who showed me the following results:
Left arm: 140
Left dorsalis pedis: 140
Left tibial: 160
Right arm: 140
Right dorsalis pedis: 150
Left tibial: 160
She'd calculated my ABI as being 1.14., which is correct but there shouldn't be such a massive difference between the two pulses. The doctor (another one at the practice) tried to say "oh well that's good news", to which I said "so why the difference?" to which you could almost see the cogs inside his head clicking and breaking apart. He then said, "Well that isn't normal in your age, no". FINALLY! I was actually relieved to hear that - as bizarre as it may sound. This explains the erection problems. I knew the issue wasn't in my head at all.
So basically what my result indicates is that there is a relatively minor "stenosis" (narrowing) in the dorsalis pedis artery, rather than the main artery going to the leg. The arteries going to the penis are very small (about 1mm) which would suggest there's a similar supply problem going on there.
I'm being referred back to Cardiology now (red flagged), really upon my insistence because I'm more concerned about supply issues "elsewhere" in the body (at first GP said vascular, but agreed based upon these results vasculitis could be ruled out as it affects all arteries equally and has more dramatic symptoms). He wants a thorough cardiac work up done. The point I made is, we should either rule them out or treat them first, then we can worry about the legs/penis at a later date.
Interestingly, using the dorsalis pedis pulse and arm pulse on the left hand side, this gave me an ABI of 1.0 - remarkably close to the 1.02 my own blood pressure machine gave me.
A lot more was said during the consultation with the doctor, but for time purposes I won't post it here (this post is long enough as it is). But I'm still very cross about this - this was pointed out to one of the GPs in November last year, who agreed the pulse couldn't be felt but because I wasn't an "actively smoking diabetic", there was nothing to worry about. Negligence - or the boy who cried wolf? I don't know.
But other than that, things are great and I've got a positive attitude now. My health anxiety seems to have evaporated.
I've been really quite busy this week (first week back to work) and have had a few friends birthday gatherings to attend.
Anyway, as some of you probably know, there had been a concern raised about the circulation to my legs/erectile dysfunction, and the Cardiologist was certain I maybe had some form of vasculitis, thus referring me back to the GP to see a vascular surgeon.
The GP immediately disagreed with the Cardiologist, saying he was wrong as it's uncommon at my age without diabetes etc, but he agreed to do the Ankle-Brachial Index test. So that was booked for Thursday 29th August. I went to the surgery to have the practice nurse perform the test, only to be told I hadn't been booked in for a long enough appointment (it takes about 15 mins + 15 mins of relaxing lying down before hand).
So I was booked in for Tuesday just past. I went in and the nurse said immediately (in a friendly sort of way) "Oh, another diabetic who hasn't controlled their sugars!" to which I said, "No, actually, I don't have diabetes". So her face went a tad confused and she told me to lie on the examination table for about 15 minutes and then she'd begin the test.
Those 15 minutes were the longest 15 minutes of my life.
After what seemed like 15 months, the nurse returned and then got her doppler out and found the brachial pulses. They sounded so clear, it was as if they were in my ear. So, this gave me an idea of what to expect with the ankle (tibial) and pedal (doralis pedis) pulse.
The nurse then examined the left arm, and there was only a minor interarm difference (about 2mmHg, which is entirely normal - a good sign). She then moved down and examined the tibial pulses using the doppler: again, both these pulses sounded as if they were in my ear, they were that clear.
But then came those elusive dorsalis pedis pulses.
She tried the left foot first, and after about 30 seconds it became apparent she had trouble finding the pulse. I said "having trouble?" to which she said "a bit". But then, we heard the pulse. Only this pulse was obviously different to the others - it sounded as if it was at the other end of the room; not as loud or forceful. She also didn't inflate the blood pressure cuff as much as the other leg pulses, indicating the pressure wasn't as high in this artery. The same happened for the other foot, only the pulse was a tad louder.
She then donned a "poker face" and said she was off to calculate the results and speak with the doctor (another sign something wasn't normal).
I sat there actually feeling fine - this has been going on for a while and it's only now they are taking me seriously. So she arrived back with the doctor, who showed me the following results:
Left arm: 140
Left dorsalis pedis: 140
Left tibial: 160
Right arm: 140
Right dorsalis pedis: 150
Left tibial: 160
She'd calculated my ABI as being 1.14., which is correct but there shouldn't be such a massive difference between the two pulses. The doctor (another one at the practice) tried to say "oh well that's good news", to which I said "so why the difference?" to which you could almost see the cogs inside his head clicking and breaking apart. He then said, "Well that isn't normal in your age, no". FINALLY! I was actually relieved to hear that - as bizarre as it may sound. This explains the erection problems. I knew the issue wasn't in my head at all.
So basically what my result indicates is that there is a relatively minor "stenosis" (narrowing) in the dorsalis pedis artery, rather than the main artery going to the leg. The arteries going to the penis are very small (about 1mm) which would suggest there's a similar supply problem going on there.
I'm being referred back to Cardiology now (red flagged), really upon my insistence because I'm more concerned about supply issues "elsewhere" in the body (at first GP said vascular, but agreed based upon these results vasculitis could be ruled out as it affects all arteries equally and has more dramatic symptoms). He wants a thorough cardiac work up done. The point I made is, we should either rule them out or treat them first, then we can worry about the legs/penis at a later date.
Interestingly, using the dorsalis pedis pulse and arm pulse on the left hand side, this gave me an ABI of 1.0 - remarkably close to the 1.02 my own blood pressure machine gave me.
A lot more was said during the consultation with the doctor, but for time purposes I won't post it here (this post is long enough as it is). But I'm still very cross about this - this was pointed out to one of the GPs in November last year, who agreed the pulse couldn't be felt but because I wasn't an "actively smoking diabetic", there was nothing to worry about. Negligence - or the boy who cried wolf? I don't know.
But other than that, things are great and I've got a positive attitude now. My health anxiety seems to have evaporated.